When healthcare quality measures fail us all 

Now that we are in the age of Pay For Performance ( P4P ) we are only beginning to learn how difficult it is to achieve the twin towers of 

• Patient Satisfaction
• Quality Care

Patient satisfaction is a very controversial subject - with the counterintuitive "percent of top" as our measuring stick and the universal acknowledgement that patient demands should not always be honored carte blanche. ( "I need my #90 Rx of Oxy for my fibro, Doc. The pain is awful." )

Can we at least be clear on the definition of Quality?

You would think we could find more solid ground with respect to how to measure quality. But NO! Here comes a study showing just how hard it is to define and incentivize quality care.

I can assure you that situations where you follow a care protocol to the letter, the patient has a bad outcome and you are penalized despite deploying the "best practice" only add to the stress that drives the epidemic of physician burnout.

Full details below ... on a best practice protocol and quality incentive that failed everyone involved
... especially the patient

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The evolution of DVT as an
"every once in a while is OK" event

Physician Burnout Rates Top 50% in latest Mayo Study - and that is not the worst of it

For a while now I have been suspicious that physician burnout rates are increasing here in the USA, especially in the last five years or so. I have been waiting for the research to catch up with my suspicions for a while now. Here is the smoking gun.

Mayo Clinic Proceedings this month published results of round two of their survey of burnout in physicians compared to burnout in the "normal population". The last round in 2011 was major news across the country and the first study that compared physician burnout rates to those of non-physician workers.

The burnout rates are what I expected. The shocker is the number of physicians screening positive for depression and suicidal ideation that no one is reporting on.

The headline trends are these

• From 2011 to 2014 physician burnout rates increased
• AND the gap between physician burnout rates and burnout rates in the normal population widened

The headline stats are these 

Date night secrets for the busy physician

Let me ask you a quick question. When was your last quality Date Night? If it was more than two months ago, this post is specifically for you.

One of the key factors in preventing physician burnout is a strong primary relationship with your loved ones. None is as important as your relationship with your spouse/significant other. 

Unfortunately a Date Night is often something that gets left out of our busy weeks. When I train groups of doctors is is not uncommon for half the hands to go up when I ask the question, "How many of you have not had a date night in the last two months." 

Date Nights are a key tool to prevent physician burnout

Here are five Date Night Secrets we teach all of our private coaching clients

Physician Burnout - EMR Shaming Has to STOP

Every time I survey a group of physicians asking, "What are the top three stressors in your practice day?" ... EMR and other documentation issues ALWAYS make the list. This is true regardless of specialty without exception. 

EMR is a slave to Big Data, designed by people who have never seen a patient and it is a huge cause of physician burnout in a significant number of doctors.

AND we can do a MUCH better job of helping our physicians clear the EMR hurdle in their day if we STOP SHAMING the people who struggle the most.

Here is a common practice scenario for a burned out physician who comes to us for coaching.

Remember the last really lousy meeting you had to sit through?

You have a whole pile of work back in your office, but you are stuck here in yet another soul sucking meeting that is going absolutely nowhere.

Poorly run meetings are incredibly common in healthcare and a MAJOR cause of burnout in physician leaders - especially if you are a "straddle leader" with both clinical and leadership roles. 

Wouldn't it be great if you could stop the downward spiral and get the meeting back on track - even if you aren't the person running it??

Let us show you how to save any meeting from the back of the room with the "Guerrilla Facilitator's Manual".

ICD-10 launch has come and gone and we all survived

Fortunately the silliness continues. Here are some Monty Python worthy ICD-10 codes for your enjoyment along with some curious holes in ICD-10 we cannot explain. In fact, the sillier this gets, the more you realize ICD-10 is not nearly as comprehensive as it truly needs to be.  ;-)

18 Silly ICD-10 Codes

- Bitten by a cow - W55.21

There are no references to any injuries from bulls. How do the Pamplona ER docs cope with this shocking oversight.

- Pecked by a chicken - W61.33
- Struck by a Macaw - W61.12

There are also references to parrot induced injuries (bite or collision with) but no references to roosters, peacocks, ostriches or parakeets. The catch all "other bird" category must suffice.

The Most Interesting Man in the world speaks ICD-10

Here in the week after implementation of ICD-10 is what the most interesting man in the world has to say ...

In our work with thousands of doctors we have created, tested and refined many tools to reverse the downward spiral of physician burnout. In this article we will show you our Top Three Tools to build the life balance you are craving.

1. The Schedule HACK
2. Bucket List Secrets
3. Quick NO, Slow YES

Before we begin it is essential you understand first that Physician Burnout is NOT a Problem

It is a DILEMMA of the highest order requiring a coordinated STRATEGY to address your specific matrix of stress sources. Your strategy is a group of 3 - 5 tools you hand select from the four parts of the burnout prevention MATRIX.

De-stressing your Practice is Step One

Once you learn how to get home sooner, you can move to Step Two:

In this article we will demonstrate why the epidemic of physician burnout is the single largest negative influence on your organization’s culture, performance and profitability.

We will then show you a promising four part intervention that can lower burnout rates and create a culture of support and engagement.

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The Quadruple Aim Blueprint White Paper Download
Four Steps to System-Wide Burnout Prevention
Download your Free Copy Now
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The prevalence of physician burnout

The prevalence of physician burnout has been exhaustively studied in all major specialties and in most first world nations over the last three decades. Here is a telling quote from one of the key researchers:

Body Scan Guided Imagery - listen or download

One of the challenges for physicians when we are off work ... is to turn the Doctor completely off ... let it all go and come all the way home.

Really, how often do you find yourself physically at home yet your mind is still fighting the demons in your practice - labs, paperwork, patients, production ... ?

When that happens you can't begin to recharge. Your worries are still draining you despite the fact that the office or hospital is miles away.

What would it be like to relax completely like this baby or this bulldog - really let it all go? When you come all the way home, leaving thoughts of work at work, only then can you begin to make deposits in your energy accounts.

Guided Imagery is a great way to unplug completely

The Body Scan is a virtual whole body massage - listen or download this MP3 below